Virtual Reality Serious Game for Musculoskeletal Disorder Prevention

  • Maria SistoEmail author
  • Mohsen Zare
  • Nabil Ouerhani
  • Christophe Bolinhas
  • Margaux Divernois
  • Bernard Mignot
  • Jean-Claude Sagot
  • Stéphane Gobron
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10851)


Musculo Skeletal Disorders (MSDs) is the most common disease in the workplaces causing disabilities and excessive costs to industries, particularly in EU countries. Most of MSDs prevention programs have focused on a combination of interventions including training to change individual behaviors (such as awkward postures). However, little evidence proves that current training approach on awkward postures is efficient and can significantly reduce MSDs symptoms. Therefore, dealing with awkward postures and repetitive tasks is the real challenge for practitioners and manufacturers, knowing that the amount of risk exposure varies increasingly among workers depending on their attitude and expertise as well as on their strategy to perform the task. The progress in MSDs prevention might come through developing new tools that inform workers more efficiently on their gestures and postures. This paper proposes a potential Serious Game that immerses industrial workers using Virtual Reality and helps them recognize their strategy while performing tasks and trains them to find the most efficient and least risky tactics.


Serious game Musculoskeletal Disorder Health application Virtual reality Virtual environment Head-mounted display 



This project was supported by the EU Interreg program, grant number 1812 as a part of the Serious Game for Health at Work towards Musculoskeleta Disorders (SG4H@W>MSD) project. The authors would like to thank Sebastien Chevriau, Maxime Larique, et Gerard Touvenot for their contribution in data collection.


  1. 1.
    CNAMTS: Cour des comptes, Rapport public thmatique: La gestion du risque accidents du travail et risques professionnels. annuel, caisse nationale d assurance maladie des travailleurs salaris, Paris (2016)Google Scholar
  2. 2.
    Bevan, S.: Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Pract. Res. Clin. Rheumatol. 29(3), 356–373 (2015). Scholar
  3. 3.
    Perruccio, A.V., Yip, C., Badley, E.M., Power, J.D.: Musculoskeletal disorders: a neglected group at public health and epidemiology meetings? Am. J. Public Health 107(10), 1584–1585 (2017). Scholar
  4. 4.
    Rezagholi, M., Bantekas, A.: Making economic social decisions for improving occupational health a predictive cost-benefit analysis. Occup. Med. Health Aff. 03(06) (2015).
  5. 5.
    Rezagholi, M.: Differential socio-economic effects of work environmental risk factors. J. Health Med. Econ. 2(2), 1–8 (2016)Google Scholar
  6. 6.
    Widanarko, B.: Interaction between physical and psychosocial work risk factors for low back symptoms. Ph.D. thesis (2013)Google Scholar
  7. 7.
    Karsh, B.T.: Theories of work-related musculoskeletal disorders: implications for ergonomic interventions. Theor. Issues Ergon. Sci. 7(1), 71–88 (2006). Scholar
  8. 8.
    Takala, E.P., Pehkonen, I., Forsman, M., Hansson, G.A., Mathiassen, S.E., Neumann, W.P., Sjøgaard, G., Veiersted, K.B., Westgaard, R.H., Winkel, J.: Systematic evaluation of observational methods assessing biomechanical exposures at work. Scand. J. Work Environ. Health 36(1), 3–24 (2010)CrossRefGoogle Scholar
  9. 9.
    Daniels, K., Gedikli, C., Watson, D., Semkina, A., Vaughn, O.: Job design, employment practices and well-being: a systematic review of intervention studies. Ergonomics 60(9), 1177–1196 (2017). Scholar
  10. 10.
    Sultan-Taïeb, H., Parent-Lamarche, A., Gaillard, A., Stock, S., Nicolakakis, N., Hong, Q.N., Vezina, M., Coulibaly, Y., Vézina, N., Berthelette, D.: Economic evaluations of ergonomic interventions preventing work-related musculoskeletal disorders: a systematic review of organizational-level interventions. BMC Public Health 17(1), 935 (2017). Scholar
  11. 11.
    Hoe, V.C., Urquhart, D.M., Kelsall, H.L., Sim, M.R.: Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Cochrane Database Syst. Rev. (2012).
  12. 12.
    Rivilis, I., Van Eerd, D., Cullen, K., Cole, D.C., Irvin, E., Tyson, J., Mahood, Q.: Effectiveness of participatory ergonomic interventions on health outcomes: a systematic review. Appl. Ergon. 39(3), 342–358 (2008). Scholar
  13. 13.
    van Eerd, D., Cole, D., Irvin, E., Mahood, Q., Keown, K., Theberge, N., Village, J., St. Vincent, M., Cullen, K.: Process and implementation of participatory ergonomic interventions: a systematic review. Ergonomics 53(10), 1153–1166 (2010). Scholar
  14. 14.
    Nastasia, I., Coutu, M.F., Tcaciuc, R.: Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review. Disabil. Rehabil. 36(22), 1841–1856 (2014). Scholar
  15. 15.
    Aghilinejad, M., Kabir-Mokamelkhah, E., Labbafinejad, Y., Bahrami-Ahmadi, A., Hosseini, H.R.: The role of ergonomic training interventions on decreasing neck and shoulders pain among workers of an Iranian automobile factory: a randomized trial study. Med. J. Islamic Repub. Iran 29, 190 (2015)Google Scholar
  16. 16.
    Driessen, M.T., Proper, K.I., van Tulder, M.W., Anema, J.R., Bongers, P.M., van der Beek, A.J.: The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review. Occup. Environ. Med. 67(4), 277–285 (2010). Scholar
  17. 17.
    Gupta, N., Wåhlin-Jacobsen, C.D., Abildgaard, J.S., Henriksen, L.N., Nielsen, K., Holtermann, A.: Effectiveness of a participatory physical and psychosocial intervention to balance the demands and resources of industrial workers. Scand. J. Work Environ. Health 44(1), 58–68 (2018). Scholar
  18. 18.
    Driessen, M.T., Proper, K.I., Anema, J.R., Knol, D.L., Bongers, P.M., van der Beek, A.J.: Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial. Occup. Environ. Med. 68(9), 674–681 (2011). Scholar
  19. 19.
    Hogan, D.A.M., Greiner, B.A., O’Sullivan, L.: The effect of manual handling training on achieving training transfer, employee’s behaviour change and subsequent reduction of work-related musculoskeletal disorders: a systematic review. Ergonomics 57(1), 93–107 (2014). Scholar
  20. 20.
    Yu, W., Yu, I.T.S., Wang, X., Li, Z., Wan, S., Qiu, H., Lin, H., Xie, S., Sun, T.: Effectiveness of participatory training for prevention of musculoskeletal disorders: a randomized controlled trial. Int. Arch. Occup. Environ. Health 86(4), 431–440 (2013). Scholar
  21. 21.
    Mehrparvar, A.H., Heydari, M., Mirmohammadi, S.J., Mostaghaci, M., Davari, M.H., Taheri, M.: Ergonomic intervention, workplace exercises and musculoskeletal complaints: a comparative study. Med. J. Islamic Repub. Iran 28, 69 (2014)Google Scholar
  22. 22.
    Shuai, J., Yue, P., Li, L., Liu, F., Wang, S.: Assessing the effects of an educational program for the prevention of work-related musculoskeletal disorders among school teachers. BMC Public Health 14, 1211 (2014). Scholar
  23. 23.
    Pront, L., Mller, A., Koschade, A., Hutton, A.: Gaming in nursing education: a literature review. Nurs. Educ. Perspect. 39(1), 23 (2018). Scholar
  24. 24.
    Lu, A.S., Kharrazi, H.: A state-of-the-art systematic content analysis of games for health. Games Health J. 7(1), 1–15 (2018). Scholar
  25. 25.
    Li, X., Yi, W., Chi, H.L., Wang, X., Chan, A.P.C.: A critical review of virtual and augmented reality (VR/AR) applications in construction safety. Autom. Constr. 86, 150–162 (2018). Scholar
  26. 26.
    Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A.L., Sandercock, P., Spiegelhalter, D., Tyrer, P.: Framework for design and evaluation of complex interventions to improve health. BMJ Br. Med. J. 321(7262), 694–696 (2000)CrossRefGoogle Scholar
  27. 27.
    Petit, A., Ha, C., Bodin, J., Rigouin, P., Descatha, A., Brunet, R., Goldberg, M., Roquelaure, Y.: Risk factors for carpal tunnel syndrome related to the work organization: a prospective surveillance study in a large working population. Appl. Ergon. 47, 1–10 (2015)CrossRefGoogle Scholar
  28. 28.
    McDermott, H., Haslam, C., Clemes, S., Williams, C., Haslam, R.: Investigation of manual handling training practices in organisations and beliefs regarding effectiveness. Int. J. Ind. Ergon. 42(2), 206–211 (2012). Scholar
  29. 29.
    Clemes, S.A., Haslam, C.O., Haslam, R.A.: What constitutes effective manual handling training? Syst. Rev. Occup. Med. 60(2), 101–107 (2010). Scholar
  30. 30.
    Collado-Mateo, D., Merellano-Navarro, E., Olivares, P.R., García-Rubio, J., Gusi, N.: Effect of exergames on musculoskeletal pain: a systematic review and meta-analysis. Scand. J. Med. Sci. Sports, 1–12 (2017). Scholar
  31. 31.
    Idriss, M., Tannous, H., Istrate, D., Perrochon, A., Salle, J.Y., Ho Ba Tho, M.C., Dao, T.T.: Rehabilitation-oriented serious game development and evaluation guidelines for musculoskeletal disorders. JMIR Serious Games 5(3), e14 (2017). Scholar
  32. 32.
    Jansen-Kosterink, S.M., Huis in’t Veld, R.M., Schönauer, C., Kaufmann, H., Hermens, H.J., Vollenbroek-Hutten, M.M.: A serious exergame for patients suffering from chronic musculoskeletal back and neck pain: a pilot study. Games Health J. 2(5), 299–307 (2013). Scholar
  33. 33.
    Deutsch, J.E.: Virtual reality and gaming systems to improve walking and mobility for people with musculoskeletal and neuromuscular conditions. Stud. Health Technol. Inform. 145(2009), 84–93 (2009). Scholar
  34. 34.
    Daesign: Serious Game Daesign: “Halte aux TMS” (FR) (2013).,
  35. 35.
    Rodrigues, M.A.F., Macedo, D.V., Pontes, H.P., Serpa, Y.R., Serpa, Y.R.: A serious game to improve posture and spinal health while having fun. In: 2016 IEEE International Conference on Serious Games and Applications for Health (SeGAH), pp. 1–8. IEEE, May 2016.
  36. 36.
    Rodrigues, M.A.F., Serpa, Y.R., Macedo, D.V., Sousa, E.S.: A serious game to practice stretches and exercises for a correct and healthy posture. Entertain. Comput. (2017).
  37. 37.
    Freitas, Hélder, Soares, Filomena, Carvalho, Vítor, Matos, Demetrio: Serious games development as a tool to prevent repetitive strain injuries in hands: first steps. In: Auer, Michael E., Guralnick, David, Simonics, Istvan (eds.) ICL 2017. AISC, vol. 715, pp. 954–964. Springer, Cham (2018). Scholar
  38. 38.
    Bartolome, N.A., Zorrilla, A.M., Zapirain, B.G.: Can game-based therapies be trusted? Is game-based education effective? A systematic review of the Serious Games for health and education. In: 2011 16th International Conference on Computer Games (CGAMES), pp. 275–282. IEEE, July 2011.
  39. 39.
    Sportillo, D., Avveduto, G., Tecchia, F., Carrozzino, M.: Training in VR: a preliminary study on learning assembly/disassembly sequences. In: De Paolis, L.T., Mongelli, A. (eds.) AVR 2015. LNCS, vol. 9254, pp. 332–343. Springer, Cham (2015). Scholar
  40. 40.
    Gobron, S.C., Zannini, N., Wenk, N., Schmitt, C., Charrotton, Y., Fauquex, A., Lauria, M., Degache, F., Frischknecht, R.: Serious games for rehabilitation using head-mounted display and haptic devices. In: De Paolis, L.T., Mongelli, A. (eds.) AVR 2015. LNCS, vol. 9254, pp. 199–219. Springer, Cham (2015). Scholar
  41. 41.
    Saenz-de Urturi, Z., Garcia-Zapirain Soto, B.: Kinect-based virtual game for the elderly that detects incorrect body postures in real time. Sensors 16(5), 704 (2016). Scholar
  42. 42.
    Vignais, N., Bernard, F., Touvenot, G., Sagot, J.C.: Physical risk factors identification based on body sensor network combined to videotaping. Appl. Ergon. 65, 410–417 (2017). Scholar
  43. 43.
    Zare, M., Malinge-Oudenot, A., Hglund, R., Biau, S., Roquelaure, Y.: Evaluation of ergonomic physical risk factors in a truck manufacturing plant: case study in SCANIA Production Angers. Ind. Health 54(2), 163–176 (2016)CrossRefGoogle Scholar
  44. 44.
    McAtamney, L., Nigel Corlett, E.: RULA: a survey method for the investigation of work-related upper limb disorders. Appl. Ergon. 24(2), 91–99 (1993). Scholar
  45. 45.
    Cicirelli, G., Attolico, C., Guaragnella, C., D’Orazio, T.: A kinect-based gesture recognition approach for a natural human robot interface. Int. J. Adv. Robot. Syst. 12(3), 22 (2015). Scholar
  46. 46.
    Pirovano, M., Ren, C.Y., Frosio, I., Lanzi, P.L., Prisacariu, V., Murray, D.W., Borghese, N.A.: Robust silhouette extraction from kinect data. In: Petrosino, A. (ed.) ICIAP 2013. LNCS, vol. 8156, pp. 642–651. Springer, Heidelberg (2013). Scholar
  47. 47.
    Ansari, N.A., Sheikh, M.J.: Evaluation of work posture by RULA and REBA: a case study. IOSR J. Mech. Civ. Eng. (IOSR-JMCE) 11, 18–23 (2014)CrossRefGoogle Scholar
  48. 48.
    Wenk, N., Gobron, S.: Reinforcing the difference between simulation, gamification, and serious game. In: Proceedings of the Gamification & Serious Game Symposium 2017 (GSGS 2017), pp. 1–3. HE-Arc / HES-SO Press, Neuchatel, 1 July 2017Google Scholar
  49. 49.
    Sisto, M., Wenk, N., Ouerhani, N., Gobron, S.: A Study of Transitional Virtual Environments. In: De Paolis, L.T., Bourdot, P., Mongelli, A. (eds.) AVR 2017. LNCS, vol. 10324, pp. 35–49. Springer, Cham (2017). Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Maria Sisto
    • 1
    Email author
  • Mohsen Zare
    • 2
  • Nabil Ouerhani
    • 3
  • Christophe Bolinhas
    • 1
  • Margaux Divernois
    • 3
  • Bernard Mignot
    • 2
  • Jean-Claude Sagot
    • 2
  • Stéphane Gobron
    • 1
  1. 1.Image Processing and Computer Graphics GroupHE-Arc, HES-SONeuchâtelSwitzerland
  2. 2.ERCOS Group (pole), Laboratory of ELLIAD-EA4661, UTBM-University of Bourgogne Franche-ComtBelfortFrance
  3. 3.Interaction Technology GroupHE-Arc, HES-SONeuchâtelSwitzerland

Personalised recommendations